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Open Access

Systematic on-site testing for SARS-CoV-2 infection among asymptomatic essential workers in Montréal, Canada: a prospective observational and cost-assessment study

Jonathon R. Campbell, Cynthia Dion, Aashna Uppal, Cedric P. Yansouni and Dick Menzies
May 10, 2022 10 (2) E409-E419; DOI: https://doi.org/10.9778/cmajo.20210290
Jonathon R. Campbell
Research Institute of the McGill University Health Centre (Campbell, Menzies, Dion, Yansouni, Uppal); Faculty of Medicine (Campbell, Menzies, Yansouni), McGill University; McGill International TB Centre (Campbell, Menzies); J.D. MacLean Centre for Tropical Diseases (Yansouni), Montréal, Que.
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Cynthia Dion
Research Institute of the McGill University Health Centre (Campbell, Menzies, Dion, Yansouni, Uppal); Faculty of Medicine (Campbell, Menzies, Yansouni), McGill University; McGill International TB Centre (Campbell, Menzies); J.D. MacLean Centre for Tropical Diseases (Yansouni), Montréal, Que.
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Aashna Uppal
Research Institute of the McGill University Health Centre (Campbell, Menzies, Dion, Yansouni, Uppal); Faculty of Medicine (Campbell, Menzies, Yansouni), McGill University; McGill International TB Centre (Campbell, Menzies); J.D. MacLean Centre for Tropical Diseases (Yansouni), Montréal, Que.
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Cedric P. Yansouni
Research Institute of the McGill University Health Centre (Campbell, Menzies, Dion, Yansouni, Uppal); Faculty of Medicine (Campbell, Menzies, Yansouni), McGill University; McGill International TB Centre (Campbell, Menzies); J.D. MacLean Centre for Tropical Diseases (Yansouni), Montréal, Que.
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Dick Menzies
Research Institute of the McGill University Health Centre (Campbell, Menzies, Dion, Yansouni, Uppal); Faculty of Medicine (Campbell, Menzies, Yansouni), McGill University; McGill International TB Centre (Campbell, Menzies); J.D. MacLean Centre for Tropical Diseases (Yansouni), Montréal, Que.
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Article Figures & Tables

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  • Figure 1:
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    Figure 1:

    Flow diagram showing selection of businesses and participants.

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    Figure 2:

    Evolution of SARS-CoV-2 infection outbreaks at businesses A (A) and B (B) (both manufacturing and supplier sector).

Tables

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    • View popup
    Table 1:

    Characteristics of included businesses in Montréal-North

    CharacteristicNo. (%) of businesses
    n = 69
    No. (%) of participants
    n = 2128
    Business sector
     Manufacturing/supplier19 (27.5)1225 (57.6)
     Auto sales and repair12 (17.4)242 (11.4)
     Childcare11 (15.9)113 (5.3)
     Public services8 (11.6)144 (6.8)
     Grocery6 (8.7)100 (4.7)
     Retail6 (8.7)84 (3.9)
     Construction4 (5.8)28 (1.3)
     Meat processing2 (2.9)183 (8.6)
     Legal1 (1.4)9 (0.4)
    Size, no. of participants
     1–511 (15.9)44 (2.1)
     6–1014 (20.3)113 (5.3)
     11–2026 (37.7)388 (18.2)
     21–5010 (14.5)350 (16.4)
     ≥ 518 (11.6)1233 (57.9)
    • View popup
    Table 2:

    Characteristics of participants

    CharacteristicTest result; no. (%) of participants*
    Overall
    n = 2128
    Positive
    n = 53
    Negative
    n = 2075
    Age, median (IQR), yr48 (37–57)49 (40–58)48 (37–57)
    Sex
     Female808 (38.0)9 (17.0)799 (38.5)
     Male1320 (62.0)44 (83.0)1276 (61.5)
    Self-reported ethnicity
     White926 (43.5)4 (7.5)922 (44.4)
     Asian444 (20.9)17 (32.1)427 (20.6)
     Black295 (13.9)21 (39.6)274 (13.2)
     Hispanic204 (9.6)6 (11.3)198 (9.5)
     Indigenous4 (0.2)0 (0.0)4 (0.2)
     Mixed17 (0.8)0 (0.0)17 (0.8)
     Other/not disclosed238 (11.2)5 (9.4)233 (11.2)
    Employment status
     Full-time2018 (94.8)51 (96.2)1967 (94.8)
     Part-time or occasional110 (5.2)2 (3.8)108 (5.2)
    Reported health factor
     Any†447 (21.0)8 (15.1)439 (21.2)
     Hypertension214 (10.0)4 (7.5)210 (10.1)
     Diabetes151 (7.1)4 (7.5)147 (7.1)
     Chronic respiratory condition64 (3.0)1 (1.9)63 (3.0)
     Heart disease31 (1.4)0 (0.0)31 (1.5)
     Other99 (4.6)1 (1.9)98 (4.7)
     None1681 (79.0)45 (85.)1636 (78.8)
    Reported smoking
     Never smoker1668 (78.4)46 (86.8)1622 (78.2)
     Current smoker331 (15.6)5 (9.4)326 (15.7)
     Former smoker129 (6.1)2 (3.8)127 (6.1)
    Previous SARS-CoV-2 test history‡
     Never tested1155 (54.3)42 (79.2)1113 (53.6)
     All test results negative882 (41.4)9 (17.0)873 (42.1)
     Any test result positive91 (4.3)2 (3.8)89 (4.3)
    Feeling on day of testing§
     “Fine, same as any other day”2098 (98.6)51 (96.2)2047 (98.6)
     “Not my best today”30 (1.4)2 (3.8)28 (1.3)
    Business sector
     Manufacturing/supplier1225 (57.6)43 (81.1)1182 (57.0)
     Meat processing183 (8.6)6 (11.3)177 (8.5)
     Childcare113 (5.3)3 (5.7)110 (5.3)
     Other607 (28.5)1 (1.9)606 (29.2)
    Business size, no. of participants
     1–544 (2.1)1 (1.9)43 (2.1)
     6–10113 (5.3)2 (3.8)111 (5.3)
     11–20388 (18.2)1 (1.9)387 (18.6)
     21–50350 (16.4)0 (0.0)350 (16.9)
     ≥ 511233 (57.9)49 (92.4)1184 (57.1)
    • Note: IQR = interquartile range.

    • ↵* Except where noted otherwise.

    • ↵† Participants could have more than 1 health factor.

    • ↵‡ Before enrolment in the study.

    • ↵§ As reported on patient questionnaire.

    • View popup
    Table 3:

    Cost per person tested of training, scheduling, saline gargle collection, sample transport and contacting of participants, assuming two 50-person businesses are visited per day by 2 mobile team members

    CostCost per person tested, $Details
    Laboratory34.00Reimbursement cost for RT-PCR to detect SARS-CoV-2
    Nonlaboratory8.67
    Training mobile team0.04
     Coordinator and mobile team personnel0.03Based on 2 d of training*
     Materials and refreshments0.01Includes meals, materials for sample collection, and sanitizing and personal protective equipment†
    Administrative personnel to schedule businesses0.80Based on 2 h per business‡
    Sample collection5.62
     Mobile team personnel2.99Based on 45 min to set up and tear down at each business and 6 min per person tested‡
     Sanitizing materials0.33Includes rags, paper towels, disinfectant and hand sanitizer†
     Personal protective equipment0.38Includes 4 masks per day and 2 gloves per participant†
     Sample collection materials1.74Includes a sample tube, a 5-mL saline ampoule and 2 biohazard bags†
     Capital purchases0.18Includes items such as chairs, tables, trash bins, Plexiglass dividers, stationery, tablets for data collection, storage bins, dollies and coolers†
    Sample transport0.54
     Mobile team personnel0.19Assuming 30 min to drop off samples and 10 min driving between businesses‡
     Vehicle and fuel0.35Assuming 60 km driven per day‡
    Administrative personnel to communicate results1.67Based on 5 min per result on average‡
    Total42.67
    • Note: RT-PCR = reverse transcription polymerase chain reaction.

    • ↵* Estimated during study for nonresearch training days.

    • ↵† See Appendix 1, Table S2, for more details.

    • ↵‡ Estimated during study.

    • View popup
    Table 4:

    Logistic regression results for factors potentially associated with ever testing positive*

    FactorNo. of participants
    n = 2128
    No. (%) of tests positiveAdjusted OR (95% CI)†
    Age (per 1-yr increase)––1.0 (0.98–1.0)
    Sex
     Female8089 (1.1)1.0 (reference)
     Male132044 (3.3)2.2 (0.9–5.3)
    Self-reported ethnicity
     White9264 (0.4)1.0 (reference)
     Nonwhite120249 (4.1)3.7 (1.4–9.9)
    Health factor‡
     None reported168145 (2.7)1.0 (reference)
     Any reported4478 (1.8)0.7 (0.3–1.5)
    Smoking history
     Never smoker166846 (2.8)1.0 (reference)
     Current or previous smoker4607 (1.5)0.7 (0.3–1.5)
    Feeling on day of testing
     “Fine, same as any other day”209851 (2.4)1.0 (reference)
     “Not my best today”302 (6.7)3.5 (0.7–16.9)
    Previous SARS-CoV-2 test history
     Never tested115542 (3.6)1.0 (reference)
     All test results negative8829 (1.0)0.4 (0.2–0.8)
     Any test result positive912 (2.2)0.7 (0.2–3.0)
    Business size, no. of participants
     1–508954 (0.4)1.0 (reference)
     ≥ 51123349 (4.0)7.9 (0.8–75.3)
    • Note: CI = confidence interval, OR = odds ratio.

    • ↵* The model accounts for clustering by business and sector.

    • ↵† Models are adjusted for all factors included in the table.

    • ↵‡ Includes hypertension, diabetes, chronic respiratory conditions (e.g., asthma), heart disease or participant-reported condition.

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CMAJ Open: 10 (2)
Vol. 10, Issue 2
1 Apr 2022
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Systematic on-site testing for SARS-CoV-2 infection among asymptomatic essential workers in Montréal, Canada: a prospective observational and cost-assessment study
Jonathon R. Campbell, Cynthia Dion, Aashna Uppal, Cedric P. Yansouni, Dick Menzies
Apr 2022, 10 (2) E409-E419; DOI: 10.9778/cmajo.20210290

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Systematic on-site testing for SARS-CoV-2 infection among asymptomatic essential workers in Montréal, Canada: a prospective observational and cost-assessment study
Jonathon R. Campbell, Cynthia Dion, Aashna Uppal, Cedric P. Yansouni, Dick Menzies
Apr 2022, 10 (2) E409-E419; DOI: 10.9778/cmajo.20210290
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